ICPHSP2006 

                                                                                                         

“Accessing Healthcare in Rural Crete, Greece: Investigating the Decision-Making Process Using a Qualitative Approach”         Click here to download Pdf file.

 

 

Authors:  

George Kritsotakis1, Nikoletta Ratsika2, Kleio Koutra2, Magdalini Pelekidou2, Zaharenia Androulaki3, Anastass. E. Philalithis3

 

Affiliation:  

1Assistant Professor, Nursing Department, TEI of Crete, Greece

2Lecturer, Department of Social Work, TEI of Crete, Greece

3Professor, Nursing Department, TEI of Crete, Greece

4Professor, Department of Medicine, University of Crete, Greece

 

 

Abstract:

Rural residents are poorer in health than people living in urban areas and this result may be partially attributed to limited access to health care. Social environment has a major significance, especially for immigrants, because their previous social support networks have been disrupted, in most cases involuntary. Social context is related to health outcomes, however it is not fully understood whether and how it is associated with health care access. This study reports on the comparison of the experiences of accessing healthcare among Greek permanent residents and immigrants with permanent resident status in rural Crete.

 

We conducted 29 purposefully sampled (21 Greeks, 8 immigrants; 14 men, 15 women), semi-structured, in-depth, individual interviews to explore the experiences and the factors influencing decision-making when accessing healthcare. The interviews were audio-taped, transcribed and reviewed for accuracy. A thematic analysis approach was used and content was coded and sorted by themes.

Both locals and immigrants stated as reasons for not accessing nearby public primary health care centers, although it was more disrupting for their daily routines, the less experienced healthcare personnel; the inadequacy of pharmaceutical products and diagnostic tests; the narrow opening hours; and the fact that some medical specialties were not existent. Social context and networks were of key significance in navigating healthcare system. Almost all participants were accessing health services in which there was a professional (doctor, nurse) they knew very well and could provide a sense of continuity in care and could help them navigate in the health system, irrespective of the distance. A lack of social support was felt as an obstacle itself and immigrants without support were trying to seek health care in their home countries and not in Greece.

 

Both structural and social factors decrease the likelihood of using rural health services. The findings point to the need for designing culturally appropriate rural health services taking into consideration the social context of the individuals.

 

Keywords:

health care access, immigrants, rural population, social support, Greece

 

 

Funding:

This study is implemented through the Operational Program ‘Education and Lifelong Learning’ (Archimedes III) and is co-financed by the European Union (ESF) and Greek national funds (NSRF 2007 - 2013).